Trauma and Stress-related disorders - Hill

Question 1

what is important to keep in mind with PTSD?

Answer 1

• *time frame**
• 3 days-1 month after trauma exposure = acute distress disorder
• if >1-2 months = PTSD

Question 2

person exposed to a traumatic event in which both were present:
- experienced actual or threatened death/injury/integrity or self OR others

they persistently re-experience the traumatic event

• persistent avoidance of stimuli associated with trauma
• persistent symptoms of increased arousal such as difficulty sleeping, irritability, difficulty concentrating, hyper-vigilance

Answer 2

PTSD

Question 3

what are the negative cognitions of PTSD?

Answer 3

• persistent and distorted sense of blame of self/others
• estrangement from others
• markedly diminished interest in activities
• inability to remember key aspects of the event

Question 4

what is the treatment for PTSD?

Answer 4

• SSRI’s
• cognitive processing therapy (support groups, eye movement desensitization reprocessing)

NOTE: -increased risk of substance abuse! avoide addictive rx like benzo’s

Question 5

what is the third most prevalent psychiatric diagnosis among veterans?

Answer 5

PTSD

- 19% of veterans also have traumatic brain injury (TBI)

Question 6

development of emotional/behavioral symptoms in response to identifiable stressor; occurring within 3 months of stressor

results in 1 or both:

• significant distress out of portion to severity of stressor
• impairment functioning

Answer 6

adjustment disorders

• not normal grief
• usually does not persist beyond 6 months (not a permanent diagnosis)

Question 7

low mood, tearfulness, or feelings of hopelessness

Answer 7

adjustment disorder with depressed mood

Question 8

nervousness, worry, jitteriness, or separation anxiety

Answer 8

adjustment disorder with anxiety

Question 9

both emotional symptoms (depression/anxiety) and a disturbance of conduct are predominant

Answer 9

adjustment disorder with mixed disturbance of emotions and conduct

Question 10

1. 1+ symptoms/deficits affecting voluntary motor or sensory function that suggest a neurological, or other medical condition
2. psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptom/deficit is preceded by conflicts or other stressors
3. the symptom/deficit is not intentionally produced, and cannot be fully explained by a general medical condition

Answer 10

diagnostic criteria for conversion disorder

• unexplained neurologic symptoms
• nurses usually think they are faking

Question 11

• paresthesias
• weakness
• paralysis
• pseudoseizures/psychogenic seizures
• involuntary movements
• sensory disturbances (blindness, mutism)

Answer 11

conversion disorder symptoms

• NOT epilepsy, is a stress/panic seizure
• the less attention you give to the seizure the better, it stresses them out even more
• pt has usually experienced some sexual/physical abuse as a child, or can have underlying personality disorder

Question 12

• voluntary control of symptoms
• self-harm/self-injection of bad stuff (feces/urine/saliva)
• bizarre or unusual symptoms

Answer 12

factitious disorder

• *Munchausen or munchausen by proxy**
• someone coming in with 40+ allergies is a red flag**

Question 13

well-established therapeutic relationship

• team approach: pain management, neurology, psychiatry
• hypnosis
• anti-anxiety medications (clonazepam when all else fails)

Answer 13

somatoform disorder treatment

Question 14

inability for recall important personal information

- usually info regarding traumatic experience

Answer 14

dissociative amnesia

Question 15

sudden, unexpected travel away from home

- inability to recall one’s past/personal identity

Answer 15

dissociative fugue

Question 16

formerly known as “multiple personality disorder”

- often survivors of sexual abuse

Answer 16

dissociative identity disorder